3T MR imaging of postoperative recurrent middle ear cholesteatomas: value of periodically rotated overlapping parallel lines with enhanced reconstruction diffusion-weighted MR imaging.
OBJECTIVE
MR diagnostic of postoperative recurrent cholesteatomas is difficult. Our purpose was to compare multishot fast spin-echo periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) diffusion-weighted MR imaging (DWI) with array spatial sensitivity encoding technique (ASSET) single-shot echo-planar DWI and late postgadolinium T1-weighted MR imaging for the detection of postoperative recurrent middle ear cholesteatomas with a 3T imaging unit.


METHODS
Thirty-five patients with suggested postoperative recurrent middle ear cholesteatoma underwent 3T MR imaging with PROPELLER DWI, ASSET echo-planar DWI, and late postgadolinium T1-weighted MR imaging. Three radiologists (2 seniors, 1 fellow) analyzed unlabeled images for visualization of recurrence. Interobserver and intraobserver agreement was assessed by using the Cohen kappa statistic test. Sensitivity, specificity, and predictive value were assessed for the 3 observers.


RESULTS
Nineteen recurrent cholesteatomas were diagnosed. PROPELLER interobserver agreement was very good (1, 0.89, 0.89) among the 3 observers. Intraobserver agreement between PROPELLER and T1-weighted imaging was very good to moderate (0.88, 0.57, 0.58). PROPELLER DWI provided less interobserver variability than other sequences, and the best sensitivity, specificity, and predictive value.


CONCLUSIONS
On a 3T imaging unit, multishot fast spin-echo PROPELLER DWI allows an easier detection of postoperative recurrent middle ear cholesteatoma than T1-weighted imaging by reducing artifacts and by its better contrast. DWI with PROPELLER is diagnostically robust and accurate.
Lehmann
P
P
Department of Neuroradiology, Amiens University Hospital, Amiens, France. lehmann.pierre@chu-amiens.fr
Saliou
G
G
Brochart
C
C
Page
C
C
Deschepper
B
B
Vallée
J N
JN
Deramond
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000473:pathology* / Q000601:surgery*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011183:Postoperative Complications / Q000473:pathology*; D012008:Recurrence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult